CCDS CDI and Quality Metrics 2

Question 1

Which quality metric measures the rate of complications that could reasonably have been prevented through optimal care?

Accepted Answer

Patient Safety Indicators (PSIs)

Answer

Case Mix Index (CMI)

Answer

Average Length of Stay (ALOS)

Answer

Geometric Mean Length of Stay (GMLOS)

Question 2

A CDI specialist notices the hospital's Case Mix Index (CMI) dropped after a coding software update. What is the MOST likely explanation?

Accepted Answer

Higher-severity DRGs are being under-coded due to documentation gaps

Answer

Increased patient volume lowered the average

Answer

The hospital admitted fewer complex patients

Answer

CMI calculations changed under the new fiscal year

Question 3

Which of the following is a Hospital-Acquired Condition (HAC) that directly affects Medicare payment if not documented as present on admission?

Accepted Answer

Catheter-associated urinary tract infection (CAUTI)

Answer

Hypertension

Answer

Type 2 diabetes

Answer

Chronic obstructive pulmonary disease (COPD)

Question 4

When calculating the Observed-to-Expected (O/E) mortality ratio, a ratio greater than 1.0 indicates:

Accepted Answer

The hospital's mortality is worse than expected

Answer

The hospital's mortality is better than expected

Answer

Documentation is complete and accurate

Answer

The hospital has a higher CMI than the national average

Question 5

Under the Hospital Readmissions Reduction Program (HRRP), readmissions within how many days of discharge are tracked?

Accepted Answer

30 days

Answer

7 days

Answer

14 days

Answer

60 days

Question 6

Which UHDDS data element is used to define the principal diagnosis?

Accepted Answer

The condition established after study to be chiefly responsible for the admission

Answer

The diagnosis that generates the highest reimbursement

Answer

The first diagnosis listed in the physician's H&P

Answer

The diagnosis with the highest ICD-10-CM code specificity